Kum'mero, kuchepetsa wa kholingo: Zoyambitsa, Zizindikiro ndi Chithandizo

Stenosis, kapena kuchepetsa wa kholingo, - kuchepetsa awiri ake. Kungakhale etymology osiyana. Stenosis, limatchedwanso kutsekeka kwa kholingo, anawagawa m'magulu angapo, amene amadalira zimayambitsa matenda. matenda angathe chifukwa cha kuvulala pa mundawo m'mimba. Abweretsa kudwala angagone kum'mero chotupa (chosaopsa kapena zilonda). Hule chitukuko cha matenda opaleshoni alowererepo, kenako zipsera kukhala. Onse akuluakulu ndi ana akhoza kuvutika kum'mero. kuchepetsa wa kholingo zimayambitsa kuphwanya kumeza ntchito (dysphagia).

ndi kuchepetsa wa kholingo Kodi

Pofuna kumvetsa ndi kudwala, muyenera kuganizira kapangidwe anatomical. Kodi kum'mero zabwinobwino? kuchepetsa wa kholingo pali nthawizonse kudwala? Tiyeni tifufuze.

The kum'mero ndi mbali ya chitetezo cha m'mimba. Iye anachita anthu pantchito thupi ntchito ya chakudya kuchokera mkamwa m'dera m'mimba. The kum'mero wathanzi amadziwikanso kwenikweni kuchepetsa, amene saletsa ndi kulimbikitsa chakudya.

Anatomical zoletsa 3 kulekanitsidwa:

• pharyngeal;
• diaphragmatic;
• bronchial.

Komanso, pali thupi kuchepetsa wa kholingo. Iwo amayamba ndi kamvekedwe ka minofu minofu. Ngakhale kumasula chiletso kutha.

iwo ili:

• mu esophageal ndi chapamimba zone mphambano;
• pa mphambano ya msempha ndi kum'mero.

Kudwala - mopitirira malire kuchepetsa kuti obstruct Ndime ya misa chakudya.

Zimayambitsa matenda

Stenosis ulipo magulu awiri:

• zogulidwa;
• kobadwa nako.

90% milandu onse amapezeka anapeza kudwala wa etymology osiyana.

Sources matenda obadwa

odwalawo amadwala kum'mero kubadwa. kuchepetsa wa kholingo amawapeza, kawirikawiri ana aang'ono. Kobadwa nako stenosis amapezeka mu nthawi ya chitukuko cha mwana wosabadwayo mpaka kubadwa.

Zimayambitsa chachikulu cha kudwala awa:

1. Ndinakumana ndi zinthu zoipa pa mayi woyembekezera. mankhwala banja, petulo, utoto kugwera thupi la mkaziyo, bwanji kukula kwa mwana wosabadwayo ndi kupundula.
2. X-ray walitsa. Ndinakumana cheza kumachititsanso yofanana mutational mu thupi. Ichi ndi chifukwa chake amayi apakati ndi m'mbali kauntala mayeso X-ray.
3. Kuti zolakwika akhoza kuyambitsa zosiyanasiyana matenda. Izi mavairasi (mwachitsanzo, chikuku), mabakiteriya mogwirizana.

Zimayambitsa matenda anapeza

Kudwala angathe ana ndi akula mokwanira. Kuthi stenosis mwina chifukwa zifukwa zingapo. Iye amatha kuonekera mu pathologies waung'ono kwambiri okhudza kum'mero.

kuchepetsa wa kholingo pafupipafupi kumachitika chifukwa cha zilonda. Kenako, izi kukokoloka kuyamba zarubtsovyvatsya. M'madera mabala anapanga, kwambiri poipa yafupika, chifukwa chakudya sanayende momasuka. Chotero ndondomeko mwina chimayambitsa ndi kudwala. Pankhaniyi, ama cicatricial kuchepetsa wa kholingo.

Zilonda chingachitike n'chiyani zinthu zotsatirazi:

• ofananira hiatal chophukacho ;
• aakulu gastritis ndi chapamimba chilonda;
• toxemia woyembekezera, amene anatsagana ndi gag reflex;
• gastroesophageal Reflux matenda ;
• amamuyambitsa timabala wa esophageal khoma pambuyo opaleshoni;
• kuphwanya mucosa lapansi.

Stenosis zingachititse kutukusira kwa kum'mero chifukwa malowedwe matenda. Kudwala angathe pa maziko a chindoko, fever, TB ndi diphtheria.

Kuvulala, monga mankhwala kapena matenthedwe amayaka la kholingo, makoma a zipangizo kuonongeka kapena zinthu zina kuti angakhalenso chifukwa cha matenda. Kuphwanya angayambe ngakhale yosayenera akufufuza mpata pa mundawo m'mimba. lamoto esophageal amafuna chithandizo chokwanira yake. Apo ayi, kungachititse kuti kuchepetsa a.

zinthu zambiri zokayikitsa kulimbikitsa kuchepetsa wa kholingo, ndi:

• phazi takuphazi;
• cheza mankhwala;
• kolajeni;
• Sclerotherapy ya mitsempha varicose.

chiletso mwina malinga ndi maonekedwe a zotupa. Mwatsoka, esophageal khansa - ndi kudwala wamba. Komabe, n'zovuta kwambiri pofuna kuchiza.

Kudwala Zingabukenso chifukwa cha kuvulala ndi matenda amene si bwanji kum'mero. Iwo kung'ambika aneurysm, anaonjezera lymph mfundo, mediastinal chotupa malo cholakwika ziwiya.

mlingo wa chitukuko

Pali magawo anayi kudwala matenda izi:

1. Mlingo woyamba wa stenosis. Mosavuta wochiritsidwayo, anapereka upo mwamsanga ndi gastroenterologist a. Pa nthawi imeneyi, m'mimba mwake wa kholingo yafupika 9 mm. Chakudya misa, koma movutikira.
2. Chachiwiri digiri - kum'mero itsekeke pang'ono 6 mm.
3. Mlingo wachitatu kuchepetsa wa kum'mero kumachitika kwa mamilimita 3.
4. Mlingo wachinayi - ndi kuchepetsa wa kholingo 1 mamilimita zimapangitsa matenda ovuta. Pa nthawi imeneyi chakudya matenda ankadya si digested mwa thupi ndipo stagnates mu intestine, patapita nthawi kudziunjikira chopondapo umene poizoni anapanga, zokhudza thupi la munthu. Ngakhale kumeza malovu munthu kutsamwa pa omangana, breathlessness ndi matenda kutsokomola.

Zizindikiro khalidwe

Chizindikiro cha pakutchulidwa wa stenosis makamaka kuphwanya ndondomeko kumeza.

Zizindikiro zina mosadziwika kuti amasonyeza kuchepetsa wa kholingo:

1. Regurgitation nestvorozhennogo akhanda mkaka. Ngati mkaka alibe curdle, kotero iwo sakanakhoza kulowa m'mimba. Kobadwa nako kuchepetsa wa kholingo kumachitika kale pa mayikidwe a kudya munali particulates. Pankhaniyi, mwanayo akukana kudya, burp zambiri, iye ali gag reflex.
2. Mu wamkulu pali chifuwa ululu kuti kumachitika chifukwa maganizo minofu kum'mero pamene akuyesa kulikankhira chakudya kudzera constriction, pa mimba.
3. Kugwiritsa salivation (hypersalivation) - zimachitika kuti unyinji wa chakudya kuti kudziunjikira mu kholingo, popanda amatha kupereka kwa m'mimba.
4. Kunyansidwa ndi kusanza.
5. Kutalikirana kwa buku lalikulu ntchofu kwa mphuno.
6. Kuchepetsa mwadzidzidzi kulemera chifukwa cha chisokonezo mu chimbudzi, kulephera pochitika chakudya kudzera kholingo ndipo amamumenya iye m'mimba. Ngati chikhalidwe ichi akufotokozera beriberi. cachexia (emaciation cha thupi) angathe matenda aakulu.

Stenosis akhoza kumva ndi chibayo. Nthawi zambiri, mu chikhalidwe ichi mu Airways kupeza Akamva chakudya. Chifukwa, matenda ya khateyo kutupa choopsa cha kholingo, ngakhale kuti chotupa magazi. mavuto ameneŵa amafuna mwamsanga alowererepo zachipatala.

njira matenda

njira ziwiri ntchito kukhazikitsa kuchepetsa wa kholingo:

1. Endoscopy. Phunzirolo lili kuchepetsa awiri. Ngati esophageal stricture anapanga (amamuyambitsa timabala), ndiye kafukufuku ameneyu ndithu nkhani. Iwo amalola kuti zowoneka fufuzani mucosa. Komanso, biopsy zichitike.
2. X-ray. Yopangidwa ndi nawo barium. Amaonetsa kudzaza zopindika, limafotokoza thupi zosiyana.

chakudya yosagwira

Pa siteji iliyonse ya stenosis, onetsetsani kuti asasiye chakudya. Muyenera kudya fractional, chakudya chochepa ndipo nthawi zambiri. Zakudya kuti achotse zakudya zonse zomwe zingachititse vuto Pomeza motero chifukwa suffocation.

Musamadye chakudya chotentha, ayenera kukhala ofunda. The kugwirizana kwa mbale - madzi, theka-zamadzimadzi kapena zofewa. Pankhaniyi, thupi liyenera kumlandira zonse zofunikira zakudya mavitamini ndi mchere.

chithandizo matenda

Kodi mankhwala analimbikitsa kuti odwala amene amapezeka kuchepetsa wa kholingo? Muzilemekeza pathologies - kutambasuka kwa malo owonongeka.

Nkofunika tisaiwale zakudya. Mpaka kuchira, muyenera kudya yekha madzi ndi theka-madzi chakudya.

Ngati pali stricture zilonda za kum'mero, wodwalayo limasonyeza mankhwala ochotsa asidi ndi wothandizila kumanga.

Komabe, mankhwala ndiwofatsa kawirikawiri zimabweretsa kumaliza kuchira. Nthawi zambiri izo Kwalamulidwa kwa yokonza mtima kwa opaleshoni.

Bougienage (yokumba kutambasuka mwa zipangizo wapadera) ntchito kukachitika kuti anapeza chosaopsa chotupa cha kholingo. Pa mankhwala ndi kukula kwa bougie zapita anasintha pang'onopang'ono kuti zokulirapo.

Mu chochitika cha matenda oyamba superimposed gastrostomy kupereka odwala kudya zakudya zopatsa nthanzi zotheka.

Esophagoplasty - ndi matumbo kupatsidwa zina dera kapena m'mimba mwa kholingo.

Zikavuta, pamene thupi amakhala atatopa kwambiri, kapena khalidwe opareshoni sizingatheke imagwiridwa gastrostomy. Pankhaniyi, thupi amatha kudyetsedwa enterally.

kupewa matenda

Zotsatira za chithandizo kumatengera pa kuchepetsa wa kum'mero wa modalities achire. Resection wa stenting esophageal ndi amaonedwa njira yabwino ya chithandizo cha matenda.

Pambuyo bougienage ndi endoscopy angakhale nayo musabise.

Kupewa stenosis kumafuna chithandizo mwamsanga pamene zizindikiro woyamba wa matendawa.

Nkofunikira kuthana ndi matenda amene angachititse kuchepetsa wa kholingo. Amayesetsa kupewa kukhudzana ndi kum'mero mankhwala ndi zinthu zina zoipa. Popewa kum'mero kuti anagundidwa ndi zinthu zakunja.